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[P2–557]: HEALTH CARE USE AMONG NEWLY DIAGNOSED ALZHEIMER's (AD) PATIENTS IN A U.S. COMMERCIAL MEDICARE ADVANTAGE INSURANCE PLAN
Author(s) -
Black Christopher M.,
Mehta Vinay,
Dubin Brady,
Khandker Rezaul Karim,
Ambegaonkar Baishali M.,
Marsico Mark
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.06.1216
Subject(s) - medicine , diagnosis code , medicare advantage , pharmacy , medical prescription , cohort , prescription drug , health care , emergency department , dementia , emergency medicine , descriptive statistics , health plan , family medicine , disease , gerontology , medical emergency , environmental health , psychiatry , population , statistics , mathematics , economics , pharmacology , economic growth
Background:Leveraging real-world data to better understand health care utilization patterns prior to and after incident AD diagnosis may help inform the clinical management of the disease. Methods: Medical and pharmacy claims data from a large, geographically diverse, commercial, US Medicare Advantage health plan, for the period 2009-2014, were used to identify cases of newly diagnosed AD. The following beneficiaries were eligible for inclusion in the analysis: aged 65 with medical and prescription drug coverage, a claims history of either 2 AD diagnostic codes or one diagnosis code and a prescription fill for a medication indicated to treat AD, and 24 months of continuous coverage in the health plan prior to and after a diagnosis. Descriptive statistics were used to estimate mean monthly health care utilization and total health plan costs in the two years prior to incident AD diagnosis. A control cohort of elderly individuals without any dementia type was constructed using a 1:1 exact match for age, gender, and geographic region. Results:A cohort of 4,039 beneficiaries was identified for inclusion in the analysis, 72% of whom were female. Health care utilization and monthly Medicare expenditures trended upward approximately 6-12 months prior to the diagnosis, with a clear peak in the 30 days immediately prior to the incident diagnosis (i.e. index month). Increases in the mean number of monthly outpatient visits (80%), emergency room visits (502%), inpatient stays (829%) and medication use (22%) were observed in the index month, compared to the 12 months prior to index. Mean per-person expenditures were greater among the AD cohort relative to controls in the indexmonth ($1,446 v $376) and in the 12 months prior to index ($3,993 v $3,449). Conclusions:These findings demonstrate that the demand for health care begins to rise modestly in the year prior to the first appearance of a diagnostic code. An improved understanding of health care patterns immediately preceding an AD diagnosis may allow health care providers to implement strategies that help patients and caregivers manage the disease. P2-558 COMPARISON OF HEALTHCARE COSTS FOR ALZHEIMER’S DISEASE (AD) PATIENTS DIAGNOSED IN INPATIENT VERSUS NON-INPATIENT SETTINGS Howard M. Fillit, Rezaul Karim Khandker, Lin Xie, Baishali M. Ambegaonkar, Furaha Kariburyo, Onur Baser, Huseyin Yuce, Christopher M. Black, The Alzheimer’s Drug Discovery Foundation, New York, NY, USA; Merck&Co., Inc., Kenilworth, NJ, USA; STATinMED Research, Ann Arbor, MI, USA. Contact e-mail: christopher. black2@merck.com